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General NPI Number Information
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NPI Number | 1144735325
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Entity Type | Individual
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Provider Name | DANIELLE M LONDON DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 12/09/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1382 S DOUGLAS BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73130-5215
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Country | US
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Telephone | 405-716-5183
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Fax |
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Provider Business Mailing Address
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Address Line | 2372 NW 191ST CT
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City | EDMOND
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State | OK
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Zip | 73012-2640
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Country | US
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Telephone | 908-892-5098
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 7005
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License Number State | OK
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